Low T Since Age 26 / Starting to Self-Dose

[Voyager1]

Thanks for the detailed post Y55G! And thanks for breaking out all the math.

Agreed that I’m lucky to have the low SHBG... and that the free T isn’t as bad as it could be. I’d love to get the E2 sensitive and totally will when I get back to the states... but it’s just not going to happen while I’m over here. :-/ But it’s super important and I will be getting bw for it every chance I get.

Saw the endo today (on a Saturday!) and she said that HRT was definitely warranted and prescribed. But apparently here the only type of test available is sustanon. :-/ I have done almost no research on that as I had no plan on using it... but, here we are. She prescribed 1ml of 250mg once per month. Within an hour of the appointment I had my first injection. Any thoughts about that dosage? I’d always planned to do the cyp twice a week.

My HCG arrives next week, and I definitely plan on using it.

[kelkel]

Thanks for the detailed post Y55G! And thanks for breaking out all the math.

Agreed that I’m lucky to have the low SHBG... and that the free T isn’t as bad as it could be. I’d love to get the E2 sensitive and totally will when I get back to the states... but it’s just not going to happen while I’m over here. :-/ But it’s super important and I will be getting bw for it every chance I get.

Saw the endo today (on a Saturday!) and she said that HRT was definitely warranted and prescribed. But apparently here the only type of test available is sustanon. :-/ I have done almost no research on that as I had no plan on using it... but, here we are. She prescribed 1ml of 250mg once per month. Within an hour of the appointment I had my first injection. Any thoughts about that dosage? I’d always planned to do the cyp twice a week.

My HCG arrives next week, and I definitely plan on using it.

Couple things. Yes, you're lucky to have low shbg in this circumstance assuming you do not possess any attributes of metabolic syndrome. When it comes to your new Endo it apparent that she is clueless about HRT by virtue of the frequency of injections prescribed. Sustanon is a blend of 4 testosterone esters, both short and long. Half life is arguably about two weeks due to the deconoate ester, meaning it'll be out of your system. The rest of the test esters are shorter. This means for the optimum effect your injections should be closer together. Your doctor is injecting you on it's terminal life putting you on a hormonal roller coaster. Make sense?

[Voyager1]

Couple things. Yes, you're lucky to have low shbg in this circumstance assuming you do not possess any attributes of metabolic syndrome. When it comes to your new Endo it apparent that she is clueless about HRT by virtue of the frequency of injections prescribed. Sustanon is a blend of 4 testosterone esters, both short and long. Half life is arguably about two weeks due to the deconoate ester, meaning it'll be out of your system. The rest of the test esters are shorter. This means for the optimum effect your injections should be closer together. Your doctor is injecting you on it's terminal life putting you on a hormonal roller coaster. Make sense?

Oh I think the cluelessness was a given. The doctors here were lovely, but I never expected them to have the same level of knowledge as an HRT specialist back home. Totally knew that 1 month was a recipe for disaster... so my plan is:
1. Use this visit to credit the legitimacy of my issue when I go home
2. Add the sust to my stock of gear
3. Switch to cyp twice weekly after a week or two

It was just nice to get some sort of something pharm grade going now to fight off the fatigue etc. Really starting to negatively affect my life. :-/

She prescribed an MRI (super cheap here - only 600 USD!) and I’m just confirming that my job’s travel insurance will cover... then I’ll do that, too.

Re: metabolic syndrome - I do have some of the symptoms, but my hope is that with an increase in my T levels and a general increase in quality of life that I can actively fight that off.

[Youthful55guy]

Thanks for the detailed post Y55G! And thanks for breaking out all the math.

Agreed that I’m lucky to have the low SHBG... and that the free T isn’t as bad as it could be. I’d love to get the E2 sensitive and totally will when I get back to the states... but it’s just not going to happen while I’m over here. :-/ But it’s super important and I will be getting bw for it every chance I get.

Saw the endo today (on a Saturday!) and she said that HRT was definitely warranted and prescribed. But apparently here the only type of test available is sustanon. :-/ I have done almost no research on that as I had no plan on using it... but, here we are. She prescribed 1ml of 250mg once per month. Within an hour of the appointment I had my first injection. Any thoughts about that dosage? I’d always planned to do the cyp twice a week.

My HCG arrives next week, and I definitely plan on using it.

I wouldn't be so quick to ditch the Sustanon, it can still be used for TRT with the right dosing. You just have to understand what's in it and how it compares to T-cyp, which is pretty much the standard in the USA.

The problem with comparing ester doses is that they have variable amounts of molecular T due varying chain lengths and molecular weights of the ester component of the drug. Therefore, you need to calculate the total molecular T in the dose and then use that to guide dosing of the stuff you have. Most guys do well on 100 to 120 mg T-cyp divided into twice weekly or E3D dosing (my favorite). Since T-cyp is about 68% molecular T (32% ester), each mL of 200mg/mL T-cyp delivers about 136 mg molecular T which is slowly released over about a weeks time. The following are the calculations for the amount of molecular T in a mL of Sustannon. As you can see, it has a slightly higher percent molecular T per mL, but the release kinetics are different than T-cyp.

Sustanon 250 is a blend of four esterized testosterone compounds:
30 mg testosterone propionate: 30 X .80 = 24 mg molecular T
60 mg testosterone phenylpropionate: 60 X 0.66 = 39.6 mg molecular T
60 mg testosterone isocaproate; 60 X 0.72 = 43.2 mg molecular T
100 mg testosterone decanoate: 100 X 0.62 = 62.0 mg molecular T
TOTAL MOLECULAR T PER ML = 24 + 39.6 + 43.2 + 60 = 166.8 mg T/mL

The idea behind frequent dosing is that it takes the emphasis off of the half-life of the ester because you are continually supplementing the ester and after a certain point you will reach pretty much a steady state of T in you blood. So let's say you decide to proceed with twice weekly dosing of Sustanon, here's how I would approach dosing.

Since most guys do well at a starting dose of 50 mg T-cyp twice weekly, that equates to about 50 X 68% = 34 mg molecular T twice weekly.

1 mL of Sustanon delivers about 167 mg molecular T, so 34 mg /167 mg/mL = 0.2 mL to get the same dose of molecular T

Therefore, start out at 0.2 mL and see how you feel in about 4-6 weeks. My normal advice would be to repeat labs, but given you location you may need to do this by "feel". If you feel the need for more, you can probably take the dose up to about 0.25 mL twice weekly, which would be slightly more what most guys need for TRT, but the dose is not as outrageous as some doses I see guys on in this and other forums.

The tricky thing is that you want to make sure E2 does not go out of range, but without labs that's going to be difficult. I hesitate to recommend that you start right away on anastrozole because without labs, you can easily dive your E2 too low and that may cause other issues (major ED for one thing). I've seen posts from some guys that claim that they can dose their anastrozole by their ability to rub out an erection but I'm not totally convinced it's a reliable method. Personally, I have noticed that when my E2 is in range, I can easily get nipple erections with certain activities but that's just a very subjective observation. It also does not tell you if/when E2 goes too high, just too low.

[Voyager1]

I wouldn't be so quick to ditch the Sustanon, it can still be used for TRT with the right dosing. You just have to understand what's in it and how it compares to T-cyp, which is pretty much the standard in the USA.

The problem with comparing ester doses is that they have variable amounts of molecular T due varying chain lengths and molecular weights of the ester component of the drug. Therefore, you need to calculate the total molecular T in the dose and then use that to guide dosing of the stuff you have. Most guys do well on 100 to 120 mg T-cyp divided into twice weekly or E3D dosing (my favorite). Since T-cyp is about 68% molecular T (32% ester), each mL of 200mg/mL T-cyp delivers about 136 mg molecular T which is slowly released over about a weeks time. The following are the calculations for the amount of molecular T in a mL of Sustannon. As you can see, it has a slightly higher percent molecular T per mL, but the release kinetics are different than T-cyp.

Sustanon 250 is a blend of four esterized testosterone compounds:
30 mg testosterone propionate: 30 X .80 = 24 mg molecular T
60 mg testosterone phenylpropionate: 60 X 0.66 = 39.6 mg molecular T
60 mg testosterone isocaproate; 60 X 0.72 = 43.2 mg molecular T
100 mg testosterone decanoate: 100 X 0.62 = 62.0 mg molecular T
TOTAL MOLECULAR T PER ML = 24 + 39.6 + 43.2 + 60 = 166.8 mg T/mL

The idea behind frequent dosing is that it takes the emphasis off of the half-life of the ester because you are continually supplementing the ester and after a certain point you will reach pretty much a steady state of T in you blood. So let's say you decide to proceed with twice weekly dosing of Sustanon, here's how I would approach dosing.

Since most guys do well at a starting dose of 50 mg T-cyp twice weekly, that equates to about 50 X 68% = 34 mg molecular T twice weekly.

1 mL of Sustanon delivers about 167 mg molecular T, so 34 mg /167 mg/mL = 0.2 mL to get the same dose of molecular T

Therefore, start out at 0.2 mL and see how you feel in about 4-6 weeks. My normal advice would be to repeat labs, but given you location you may need to do this by "feel". If you feel the need for more, you can probably take the dose up to about 0.25 mL twice weekly, which would be slightly more what most guys need for TRT, but the dose is not as outrageous as some doses I see guys on in this and other forums.

The tricky thing is that you want to make sure E2 does not go out of range, but without labs that's going to be difficult. I hesitate to recommend that you start right away on anastrozole because without labs, you can easily dive your E2 too low and that may cause other issues (major ED for one thing). I've seen posts from some guys that claim that they can dose their anastrozole by their ability to rub out an erection but I'm not totally convinced it's a reliable method. Personally, I have noticed that when my E2 is in range, I can easily get nipple erections with certain activities but that's just a very subjective observation. It also does not tell you if/when E2 goes too high, just too low.

Whoa... Whoa whoa. This is gold. Thank you, Y55G! Truly amazing. A great way to keep using a prescription while keeping hormone levels in check. Incredibly complex breakdown... but again, super awesome!

Yes, I'm worried about E2 for sure. And because of my current stats (went from about 13% body fat to almost 30% in the past 3 years, some of which I credit to this... though not an excuse) it's something I need to stay on top of. I hear that Aromasin doesn't crash E2 as hard as something like Adex... Maybe I should take 12.5mg/day just in case until I can get labs done?

On the upside... I'm into day 2 after my first injection. Though I know things aren't even close to stabilized yet, I already can tell a very noticeable difference with my attention span, energy level, and ability to get out of bed in the morning. That in itself has been worth it!